Library

Rash (Zhen) is caused by wind-heat pathogen affecting the Taiyin Lung Meridian. It is completely different from Smallpox (Dou), and its treatment method is also distinct. Generally, the occurrence of rash is due to contracting the prevailing seasonal epidemic qi. Regardless of age or gender, the transmission varies. Some call it "Zhenzi," others "Mazi." In the Wu region, it is commonly referred to as "Sha." The general name is Rash, which is a different disease, not the rash associated with Smallpox.

Its morphology is dense like needle heads, and its color is pale like peach blossoms. A greater number of rashes on the head and face is auspicious because the Lung resides at the highest position. Upper symptoms include coughing and sneezing; lower symptoms include diarrhea, reflecting the exterior-interior relationship between the Lung and the Large Intestine. Treatment should employ acrid-cool methods, avoiding warm-hot methods, as the Dui trigram symbolizes dryness overcoming metal. Acrid-dispersing methods are suitable, while bitter-cold methods are not, because the Lung governs the skin and hair. Using warm herbs causes fire to scorch metal (Lung), leaving the toxin unresolved; using cold herbs causes heat to lie latent internally, preventing the pathogen from transforming. Therefore, the primary approach uses herbs such as Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Niubangzi (Arctii Fructus), Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), and Jiegeng (Platycodonis Radix). The main goal is to vent the eruption thoroughly, allowing the toxin to fully emerge through the skin, thereby avoiding the danger of internal attack on the organs. This is the best strategy.

In winter, when severe cold prevents eruption, slightly add Mahuang (Ephedrae Herba). In summer, when intense heat prevents resolution, add Lianqiao (Forsythiae Fructus). If Stomach Qi is weak, assist with rice water, as the pathogen is not in the Stomach. If Middle Qi is solid, regulate with Zhishi (Aurantii Fructus Immaturus) and Houpo (Magnoliae Officinalis Cortex); temporary use facilitates recovery. Regarding pregnant women, Smallpox tends not to cause miscarriage because Smallpox favors internal fullness; Rash tends to cause instability because Rash favors internal emptiness. However, if one desires to secure the fetus but fails, why is this? Because the uterus is connected to the Kidney, and Metal (Lung) is the mother of Water (Kidney). When Rash erupts, the blood of the Lung meridian flows entirely outward, cutting off the source of generation for the Kidney meridian, leaving it unable to nourish itself. Thus, the fetus inevitably aborts and rarely remains. How can this be compared to Smallpox? Furthermore, Smallpox often becomes mild within two to three days, whereas Rash is considered safe only when it gradually fades within six to seven days; this is another difference.

Note: Recalling the years of Ji Chou, Ren Chen, and Gui Si, Rash was rampant. Regardless of age, the entire region was affected. Upon my diagnosis, patients presented with coughing, sneezing, diarrhea, and even red eyes, epistaxis, sore throat, and hoarseness. The public treated them as Smallpox. I stated, "These all belong to Lung Meridian syndromes; they are Rash, not Smallpox." Consulting medical texts, I found records only in *Youke Zhunsheng* (Standard Guidelines for Pediatrics), yet I was not fully satisfied. My brother-in-law, Sun Zidaqi, who specialized in pediatrics and loved learning, showed me Zhu Huimin's *Chuanxin Lu* (Record of Heart Transmission). Reading it, I found the methods orderly and the treatments effective. Following these, I succeeded in nearly every case. Regardless of variations—whether accompanied by food stagnation, hemorrhage, or pregnancy—I made slight modifications, sometimes adding digestive or clearing methods. Consequently, no pregnancies were lost. If a miscarriage occurred, the Rash invariably healed. At that time, I achieved results effortlessly. How could I forget its origin? I record this here.

Case Records:
1. A woman had food stagnation from eating noodles, resulting in very dense Rash. I initially administered herbs to support the eruption. Due to chest and diaphragm distension, I added Laifuzi (Raphani Semen) and Houpo (Magnoliae Officinalis Cortex), after which her chest relaxed, and the Rash erupted. However, most patients could eat; this was a rare exception.

2. A man developed Rash but took cooling herbs, leading to abdominal pain and diarrhea, with pale white Rash. I prescribed Baifuling (Poria), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix), Jiegeng (Platycodonis Radix), Bohe (Menthae Haplocalycis Herba), and Wei Jiang (Zingiberis Rhizoma Preparatum). After two doses, abdominal pain ceased, the Rash turned red and bloomed, and he recovered.

3. A man developed Rash in summer. The pediatrician added Mahuang (Ephedrae Herba) and Qianghuo (Notopterygii Rhizoma et Radix), causing persistent epistaxis, sore throat, and hoarseness. I prescribed Xuan Shen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), Gan Jie (Licorice and Platycodon), Shuniu (Arctii Fructus), and Bohe (Menthae Haplocalycis Herba) to cool and settle him. Generally, Rash is not feared for being excessive but for being latent. Latency leads to panting, nasal flaring, and potentially progresses to infantile malnutrition (Gan), dysentery, or consumption, often proving fatal. Additionally, some individuals experience multiple eruptions in their lifetime, caused by seasonal qi, unlike Smallpox which occurs only once in a lifetime. This must be known.

Jingfang Yin (Schizonepeta and Saposhnikovia Decoction)
Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), Shuniu Zi (Arctii Fructus, roasted and ground), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Su Bohe (Menthae Haplocalycis Herba), Chenpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix) (each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (0.2 qian), Shanzha Rou (Crataegi Fructus) (1.5 qian).
Add one slice of Shengjiang (Zingiberis Rhizoma Recens), a pinch of Yuanxu (Coriandri Fructus); if unavailable, use Yuanxu Zi. Once the Rash is fully vented, remove Jingjie and Fangfeng. If the chest/diaphragm feels unrelieved, add Zhishi (Aurantii Fructus Immaturus) and Houpo (Magnoliae Officinalis Cortex). For excessive phlegm, add Suzi (Perillae Fructus). For severe diarrhea, remove Shuniu Zi. For sore throat, add Shegan (Belamcandae Rhizoma). For fire-toxin, add Xuan Shen (Scrophulariae Radix). For abdominal pain, add Fuling (Poria) and Houpo (Magnoliae Officinalis Cortex). After two doses, remove Jingjie and Fangfeng, add Bohe (Menthae Haplocalycis Herba) 1 qian, and Zhike (Aurantii Fructus) 1 qian.

Rash originates from the Lung Meridian. Secular practitioners often mistakenly use drying herbs like Qianghuo (Notopterygii Rhizoma et Radix) targeting the Taiyang Meridian; this is an error. Its harm includes sore throat and irritability, though relatively mild. Another error is using Shigao Tang (Gypsum Decoction) to cold the Stomach; this leads to sudden changes in condition and immediate death. Those who suffer unjustly should indeed fear this greatly.